June 2012 - PowerPoint PPT Presentation

Benefits 2012/2013 - - An HR Liaison Presentation
1 / 12

  • Uploaded on
  • Presentation posted in: General

Benefits 2012/2013 - - An HR Liaison Presentation. June 2012. Ellen Gerescher. Employee Benefits Manager A&M System Office. Contract Renewals. The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.

Download Presentation

June 2012

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript

June 2012

Benefits 2012/2013 - - An HR Liaison Presentation

  • June 2012

Ellen Gerescher

Employee Benefits Manager A&M System Office

Contract renewals

Contract Renewals

  • The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

  • Renewed contracts with both BlueCross BlueShield and Medco will result in significant savings

    • Lower administrative fees, greater network discount savings

Benefit changes for 9 1 12

Benefit Changes for 9-1-12

Tobacco User Additional Premium

Consolidation of Health plans

Dependent Audit

What constitutes a tobacco user

What constitutes a tobacco user?

This can be defined many different ways.  The A&M System will follow the standard used by the ERS in order to be consistent with other State entities.  A tobacco user is someone who has utilized tobacco more than five times in the previous three months.

Two years of changes

Two Years of Changes

  • Changes for 2011-12

    • Merged two A&M Care plans into one plan

  • Changes for 2012-13

    • Merging the Scott & White Health Plan into the A&M Care Plan

Behind the consolidation

Behind the Consolidation

  • Larger, single risk pool eliminates selection bias and adverse selection

    • SWHP enrollment has decreased over the past several years

    • Costs have increased

      • Members aged

      • Costs for doctors outside the clinic increased

    • Plan design continued to mirror that of the A&M Care plan

Transitioning from scott white

Transitioning from Scott & White

  • While plan choice may be gone ---- physician choice remains

  • Decrease in monthly premiums

  • Virtually all S&W doctors are in the BlueCross BlueShield network

    • BCBS phone number for Scott & White members with questions: 1-866-231-5581

Transitioning cont

Transitioning (cont.)

  • The Scott & White pharmacies are in the Medco network

  • Medco website for information about coverage for specific drugs: http://www.medcohealth.com/consumer/site/openenrollment?accessCode=TAMRXBEN14597

New for the a m care plan

New for the A&M Care Plan

Starting August 1, your A&M UIN will be your BlueCross BlueShield ID Number, beginning with TXW (for employees) and ZGB (for retirees) – all existing members will get new ID cards

Benefits Value Advisor – service that helps employees by locating providers, providing cost estimates, scheduling procedures, etc.

New for the grad plan

New for the Grad Plan

  • Expanded to be compliant with Federal Healthcare reform

    • No plan-year maximum for drug coverage

    • Preventive care provided at 100%

    • No pre-existing coverage limitation for members under age 19

Dependent audit

Dependent Audit

Approximately 10,000 employees with dependent medical coverage audited

Approximately 750 dependents dropped; however many dropped voluntarily

Audit continues for those with dependents on dental, vision and dependent life only

June 2012

Thank You!

Ellen Gerescher

System Benefits Administration



  • Login